Utilization Management Administration Coordinator – Home Health
New
H
HumanaHealthcare utilization management
United States, Ability to work between the hours of 8 a.m. and 8 p.m. ESTFull-TimeJunior
Salary40,000 - 52,300 USD per year
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Job Details
- Experience
- 1 or more years of administrative, technical support, customer service, or related experience
- Required Skills
- Microsoft ExcelMS OfficeCustomer service
Requirements
- Have 1 or more years of administrative, technical support, customer service, or related experience.
- Have excellent verbal and written communication skills.
- Be able and willing to support customer service and intake through high-volume inbound telephone interactions.
- Be able to communicate by telephone while navigating multiple systems and screens, documenting interactions, and processing information accurately.
- Have working knowledge of MS Office, including Word, Excel, and Outlook, in a Windows-based environment, and be able to learn new systems quickly.
- Have access to high-speed DSL or cable modem internet for a home office; satellite and wireless internet service are not allowed.
- Provide a dedicated office space without ongoing interruptions to protect member PHI/HIPAA information.
- Be available to work between 8 a.m. and 8 p.m. EST; hours may include rotational weekend work.
- Adapt to changing work assignments based on business and operational needs.
- Preferred: proficiency with electronic medical record and documentation programs.
- Preferred: experience with medical terminology and/or ICD-10 codes.
- Preferred: bachelor's degree in Business, Finance, or a related field.
- Preferred: member, provider, call center, or customer service telephone experience, and experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.
Responsibilities
- Handle inbound calls from providers, members, and other stakeholders and provide customer service.
- Support intake and processing of utilization management and prior authorization requests.
- Create and process authorization cases.
- Generate letters and other correspondence.
- Triage faxes and shared mailboxes and route documentation.
- Document interactions and accurately process information while navigating multiple systems.
- Perform calculations, data processing, and other non-clinical administrative functions.
- Adapt to changing assignments and operational priorities.
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